How much rates vary
Facilitymedian $1,514 · 10th to 90th $550 to $3,388Professionalmedian $209 · 10th to 90th $129 to $1,738
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $281.84 | Professional | None | $125.89 | $186.21 | $281.84 |
BCBS Tennessee Setting Facility Modifier None Typical Low $831.76 Median $1,584.89 Typical High $3,467.37 | Facility | None | $831.76 | $1,584.89 | $3,467.37 |
BCBS Tennessee Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $407.38 | Professional | None | $147.91 | $213.80 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,318.26 Typical High $2,454.71 | Facility | None | $389.05 | $1,318.26 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $338.84 | Professional | None | $123.03 | $181.97 | $338.84 |
Lucent Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $380.19 | Professional | None | $128.82 | $218.78 | $380.19 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $93.33 Typical High $138.04 | Professional | 52 · Reduced service | $63.10 | $93.33 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $37.15 Typical High $56.23 | Professional | 53 · Discontinued | $25.12 | $37.15 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $141.25 Typical High $208.93 | Professional | 54 · Surgery only | $95.50 | $141.25 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $28.18 Typical High $41.69 | Professional | 55 · Aftercare only | $19.05 | $28.18 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $18.62 Typical High $28.18 | Professional | 56 · Pre-op care only | $12.59 | $18.62 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $131.83 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $89.13 | $131.83 | $194.98 |
Where Tennessee sits
The same service costs 9.9 times more in Colorado than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
CO $4,605MT $466
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.